TAMPA — A Hillsborough County ambulance company once locked out of the business of transporting patients between medical centers is now free to compete with two other companies that dominate the business.

The county’s Public Transportation Commission removed a restriction this week on TransCare Medical Transportation Services that confined the company to answering 911 calls and transporting mentally ill patients.

The 911 business is not as profitable as transporting patients between medical centers because 911 callers are often uninsured and the calls are often canceled before the ambulance arrives.

The Public Transportation Commission, which regulates vehicles for hire such as ambulances, wreckers and limousines, voted 3-1 to remove the limitation on Trans­Care. PTC board members Victor Crist, Ken Hagan and Al Higginbotham, all county commissioners, voted yes, and Tampa City Councilman Frank Reddick voted no.

For 13 years, American Medical Response and AmeriCare Ambulance Service have monopolized the lucrative inter-facility transport service, arguing that they had sufficient ambulances to handle the demand. And the PTC has repeatedly upheld the restrictions on TransCare, the last time in 2010.

“It’s incredible to me that an onerous restriction like this could be enforced for so long, and it’s a testament to the power that the incumbent ambulance companies had exerted on that commission,” said Steven Anderson, attorney for TransCare.

An attorney for American Medical Response could not be reached. A call to AmeriCare was not returned.

Anderson said he thinks Trans­Care was finally successful because of new members on the transportation board, including Crist, the chairman, and Higginbotham, who took over after former member Les Miller, also a county commissioner, abruptly resigned in the middle of a PTC meeting.

TransCare argued that response times for the other two companies were getting longer and another service could help. Former county Fire Chief Bill Nesmith testified on Trans­Care’s behalf.

“He testified the system was broken by the way it was being manipulated by two incumbent ambulance systems, and it was putting lives at risk,” Anderson said.

TransCare is a subsidiary of the Crisis Center of Tampa, a nonprofit that provides free emergency counseling.

Crist, the PTC chairman, said he had long favored leaving AMR and AmeriCare in charge of the medical transport sector.

“After doing more research, it was clear to me we needed a level playing field and we needed more service,” Crist said. “It will help improve response times and a create a healthy, competitive environment.”

An outstanding court case could affect the PTC decision. Last month, Circuit Judge Steven Scott Stephens ruled the PTC was not bound by a 1996 agreement in which Trans­Care agreed to limit its business to 911 calls and transporting mentally ill patients. AMR is appealing the ruling.